Medical education, palliative care and moral attitude: some objectives and future perspectives.

CONTEXT: Adequate medical education has 3 interrelated aspects: theoretical knowledge, practical skills and the personal attitude of the doctor. The current emphasis on medical science diverts attention from the importance of the attitude aspect of medical education. We argue that the integration of palliative care into medical curricula can correct this imbalance between knowledge, skills and attitude. In our view, incorporating palliative care into medical training not only improves the quality of palliative care, but also contributes to the moral quality of the doctors being trained. To support our argument we emphasise the moral aspects of attitude. Moral attitude focuses on the capacity to respond to others in a humane manner and can be compared with the way a virtuous doctor acts. We show the crucial role this moral attitude plays in palliative care and the surplus value palliative care education can have in general medical training. PERSPECTIVES: We suggest that clinical experience in palliative care, supplemented by reflection on narratives about chronically ill or dying patients and mourning or ageing processes, offers prospects for developing palliative care education. These perspectives can contribute to the transformation of the present 'hidden curriculum' of contemporary medical education, which implicitly shapes the student's moral attitude, into a future more explicit enculturation into the medical realm. Ultimately, this will improve health care as a whole.